Ziva is a 5 year old, spayed, German Shepherd that has been a patient at Post Pet Hospital since she was 9 weeks old. On September 9, 2016, Ziva had an appointment for her annual exam, vaccines and heartworm test. This is when we discovered that Ziva was heartworm positive. Heartworms live in the heart and pulmonary arteries. In advanced cases, this may lead to coughing or hacking with heavy infestations of heartworms. Symptoms can range from fatigue while exercising to difficulty breathing to weight loss to dark urine caused by urinary protein loss in severe cases. When there are adult male and female heartworms, they reproduce and create microfilariae. Microfilariae are then transmitted from dog to dog through a mosquito.
Soon after Ziva’s diagnosis, we took radiographs and did bloodwork to stage the heartworm disease and make sure there weren’t any underlying problems that would complicate heartworm treatment. Bloodwork revealed an elevated white blood cell count which indicates infection, but the liver and kidneys were functioning well. Radiographs showed that the pulmonary vessels were prominent and right sided cardiomegaly, or enlargement of the right side of the heart. There were also densities noted in the lung field from the heartworm infection. Dr. Grosser prescribed steroids and antibiotics to help with the inflammation and infection.
To treat heartworm disease, we use a product containing melarsomine dihydrochloride, commonly known as Immiticide. It is an injectable solution that is given intramuscularly to the dog in the lumbar region of the back and administered in 3 stages. Before we want to start the injections to kill off the adult worms, we want to start the patient on a monthly heartworm preventative under supervision to kill the baby worms. Once the patient has successfully started the prevention without any adverse reactions, we can then continue the process of treating the adult worms.
The first injection was given the same day Ziva underwent her blood screening and x-rays. An extra dose of steroids was given to help combat any inflammation caused by the presence of the worms. Thirty days later, Dr. Grosser administered a back to back dose of Immiticide 24 hours apart. Doing the injections in 3 stages kills the worms gradually making it less risky for embolism or shock. It is very important to keep the dog calm during treatment. Overexertion increases heart rate and oxygen demand which, in turn, may cause an embolism or a blockage of an artery from the heartworm congestion. These injections can be very painful and swelling can occur. Ziva exhibited both pain and swelling which was relieved some with the use of steroids. Six months after the last injection, on April 17, 2017 Ziva returned for her follow-up heartworm test and the results were negative.
Heartworm treatment is very costly, painful, and often times, easily preventable with a monthly heartworm preventative. It can either be a once a month chewable or topical application but it must be purchased from a veterinarian or with a prescription.